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General NPI Number Information
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NPI Number | 1487984530
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Entity Type | Individual
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Provider Name | LESLIE CRIADO PSYD, MSW
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Gender | Female
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | CHARDON AVE ANGEL RAMOS FOUNDATION 2 APS HEALTHCARE PR
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-641-0773
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Fax | 787-641-0776
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Provider Business Mailing Address
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Address Line | 3326 AVE BOULEVARD 3RA SECC LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 939-275-3335
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Fax | 787-261-9090
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6038
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License Number State | PR
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